ABSTRACT 66

Abstract

Background and aims: Critically ill children in the Pediatric Intensive Care Unit (PICU) are exposed to a multitude of risk factors for sleep disturbances, during a time when the restorative benefits of sleep are the most important for neurocognitive development. Increased delta EEG activity during childhood is associated with high levels of synaptic density and activity. Traditional methods of visual inspection of the EEG to determine sleep architecture provide no insight into time-dependent effects of ICU interventions across the sleep period. Aims: Using objective and quantitative data acquisition and analysis techniques, our overall objective is to characterize the sleep experience of critically ill children with EEG and power spectral analysis using the fast Fourier Transform. Methods: After IRB approval and consent, children admitted to the PICU requiring mechanical ventilation for primary respiratory failure had continuous EEG recordings for a minimum of 24 hours. The EEG was analyzed using power spectral analysis with the fast fourier transform (FFT), and the spectral distribution was categorized into frequency bands. ICU subjects were age and gender matched to healthy controls from the TuCASA cohort. Results: Seven critically ill children had EEG recordings for 24 hours or more during mechanical ventilation. When compared to age and gender matched controls, children in the PICU demonstrated no evidence of homeostatic regulation of delta sleep across both the nocturnal and 24 hour periods.FigureConclusions: The results of this study will inform interventional studies to optimize sleep of critically ill children undergoing active neurocognitive development, challenging a PICU paradigm and culture that assumes children are experiencing restorative sleep during critical illness.